The Affect On Paraspinal Muscles Between Paraspinal Muscle Space Approach And Poserior Approach In The Treatment Of Thoracolumbar Fractures

Objective:Thoracolumbar fracture patients by comparing the paraspinal muscles maximum coronal diameter, sagittal diameter, cross-sectional area (CSA), T2signal intensity values in different surgical approach, different periods of change differences, analyze and explore treatment approach by Wiltse muscle gapthe thoracolumbar fractures advantage and characteristics.Method:Choose a hospital from Jinan Orthopedic Surgery January2009to January2011, accepted thoracolumbar spine fracture without spinal decompression and posterior pedicle screw fixation in37patients. Randomly divided into groups A, B, A group of rows Wiltse muscle gap into the pedicle screw fixation; posterior midline pedicle screw fixation in the tradition of group B line.(1) take the patients before and after3h, After7d, the postoperative60d, the level of12months after MRI axial images, measuring various periods paraspinal muscles average maximum coronal diameter value, sagittal diameter values and crossThe cross-sectional area values and compared.(2) take the patients before and after surgery3h,48h, After7d, after one month, three months, six months,12months T11/12T12/L1segment MRI broken bit liketake the psoas muscle center outward about15mm2area measuring the average T2signal intensity values and assessment.Results:A, B group preoperative coronal diameter, maximum sagittal diameter, cross-sectional area are above the normal level. After3hours A-. B group of the three sets of values peaked, group A, thereafter begins to decline steadily to close to the normal12months after surgery; B group presents a more substantial downward trend, to12months while the decline the degree has exceeded the normal value. After statistical comparison, A、B preoperative three months after three sets of values p>0.05, not statistically significant. A、B postoperative3hours,3days,7days,12months, three sets of data show p<0.01, statistically significant. Group A after3hours,3days,7days, three sets of data is significantly less than group B, A group after12months of the three sets of data is significantly larger than the B group. A, group B before surgery, after6months, similar to the T2signal ratio, were1.07,1.00Sakon; A group after3hours T2signal ratio peaked at48hours,7days,1month,3months,6months decreased to close to12months when the normal ratio value; reach the peak value of the B group of the same after three hours, after T2signal ratio in each time node gradually increase to1month after startThe significant decline in the value exceeded normal rate dropped to12months.1、Conclusions:The extent of the damage after Wiltse muscle space approach to the treatment of thoracic bone fracture surgery early in a significant reduction in the paraspinal muscles, and reduce the chance of secondary injury occurs in inflammatory destruction paraspinal muscles.2、The Wiltse muscle space approach to the treatment of the thoracic bone fractures can avoid paraspinal muscle damage nerves, and blood vessels, to protect the paraspinal muscle function recovery, reducing the possibility of paraspinal muscle degenerative muscle atrophy.3、Image data by means of magnetic resonance imaging can provide a more clear understanding of the paraspinal muscle damage denaturation process node is further clear of the degeneration of paraspinal muscle function.